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Impact of diabetes on outcomes in patients with low and preserved ejection fraction heart failure: an analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme.
- Source :
-
European heart journal [Eur Heart J] 2008 Jun; Vol. 29 (11), pp. 1377-85. Date of Electronic Publication: 2008 Apr 14. - Publication Year :
- 2008
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Abstract
- Aims: To determine whether the risk of adverse cardiovascular (CV) outcomes associated with diabetes differs in patients with low and preserved ejection fraction (EF) heart failure (HF).<br />Methods and Results: We analysed outcomes in the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) programme which randomized 7599 patients with symptomatic HF and a broad range of EF. The prevalence of diabetes was 28.3% in patients with preserved EF (>40%) and 28.5% in those with low EF (<or=40%). Diabetes was associated with a greater relative risk of CV death or HF hospitalization in patients with preserved EF [hazard ratio (HR) 2.0 (1.70-2.36)] than in patients with low EF [HR 1.60 (1.44-1.77); interaction test P = 0.0009]. For all-cause mortality, the risk conferred by diabetes was similar in both low and preserved EF groups. The effect of candesartan in reducing CV morbidity and mortality outcomes was not modified by having diabetes at baseline (P = 0.09 test for interaction).<br />Conclusion: Diabetes was an independent predictor of CV morbidity and mortality in patients with HF, regardless of EF. The relative risk of CV death or HF hospitalization conferred by diabetes was significantly greater in patients with preserved when compared with those with low EF HF.
- Subjects :
- Aged
Angiotensin II Type 1 Receptor Blockers therapeutic use
Benzimidazoles therapeutic use
Biphenyl Compounds
Diabetic Angiopathies complications
Epidemiologic Methods
Female
Heart Failure complications
Heart Failure drug therapy
Humans
Male
Prognosis
Tetrazoles therapeutic use
Treatment Outcome
Diabetic Angiopathies mortality
Heart Failure mortality
Stroke Volume physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1522-9645
- Volume :
- 29
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- European heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 18413309
- Full Text :
- https://doi.org/10.1093/eurheartj/ehn153